超声及螺旋CT对异位阑尾炎的诊断价值对比分析

Comparative Analysis of the Diagnostic Value of Ultrasound and Spiral CT in the Diagnosis of Ectopic Appendicitis

目的探讨分析超声及多层螺旋CT(MSCT)对异位阑尾炎的诊断价值。方法回顾性分析于2011—2013年该院收治的术中及术后病理证实异位阑尾炎患者28例,比较超声和螺旋CT在诊断异位阑尾炎中的灵敏度和诊断价值。结果 28例患者中术前超声诊断为异位阑尾炎16例,漏误诊12例,诊断准确率57.1%;CT诊断异位阑尾炎24例,漏误诊4例,诊断准确率85.7%。术中及术后病理证实为高位阑尾14例.盆腔阑尾9例,左位阑尾3例,盲肠后腹膜外位2例。其中单纯性11例,化脓性13侧,阑尾周围脓肿4例。结论超声由于简单快捷,费用相对便宜,可以重复检查,可作为首选检查方法,但对于超声检查提示阴性的病例,特别是对于患者肥胖,肠腔内气体干扰较大,年龄较小、主诉不清的患儿以及考虑临床考虑位置异常的患者,多层螺旋CT扫描可以考虑作为诊断和鉴别诊断的重要手段。

Objective To study the analysis of ultrasonic and multislice CT（MSCT） in the diagnosis of ectopic appendicitis value. Methods A retrospective analysis of our hospital in 2011~2013 intraoperative and postoperative pathology confirmed28 patients with ectopic appendicitis, comparing ultrasonic and spiral CT in the diagnosis of sensitivity and diagnostic value of ectopic appendicitis were analyzed. Results 28 patients in the preoperative ultrasound diagnosis of ectopic appendicitis in 16 cases, 12 cases were misdiagnosed, leakage diagnosis accuracy rate 57.1%; 24 cases of CT in the diagnosis of ectopic appendicitis to leak, 4 cases were misdiagnosed, the diagnostic accuracy of 85.7%. Intraoperative and postoperative pathology confirmed appendix 14 cases for high. 9 cases of pelvic appendix, left an appendix 3 cases, outside the cecum retroperitoneum in 2 cases. Simple 11 cases, suppurative 13 side, periappendicural abscess in 4 cases. Conclusion Ultrasound as simple and quick, relatively cheap cost, can be repeated to check, can be used as the preferred examination method, but for us revealed negative cases, especially for the patients with obesity, gas interference within the lumen is bigger, consider abnormal location of patients, CT scanning can be considered as an important means of diagnosis and differential diagnosis.